Rate-Control vs Rhythm-Control for Atrial Fibrillation: A Controversy Reluctant to Die in the Era of Dronedarone? Pages 2-3

Carlos Escobar1, José Luis Merino1, Vivencio Barrios2 and Francisco J. Alonso-Moreno3

1Department of Cardiology, Hospital Universitario La Paz, Madrid; 2Department of Cardiology, Hospital Universitario Ramón y Cajal, Madrid; 3Primary care center Silleria, Toledo, Spain

DOI: http://dx.doi.org/10.12970/2311-052X.2013.01.01.1

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Abstract: Although restoring atrial fibrillation to sinus rhythm seems beneficial in patients with non-permanent AF, clinical trials have not observed any convincing benefit of a rhythm-control strategy compared with a rate-control strategy. This may be related with the adverse effects associated with antiarrhythmic drugs that may offset any beneficial effect of this approach.

Dronedarone has been recently approved for the treatment of patients with paroxysmal or persistent atrial fibrillation and is the only antiarrhythmic agent that has shown a benefit in the reduction of the incidence of hospitalization due to cardiovascular events or death compared with placebo.

As AFFIRM is the most relevant clinical trial that has suggested that rhythm and rate control rates strategies are similar, and ATHENA the most important study analyzing the effects of dronedarone in patients with atrial fibrillation, the results of both studies have been compared.

Keywords: Atrial fibrillation, antiarrhythmic drugs, dronedarone, AFFIRM, ATHENA. Read more